CAJ | 학술논문

目的：在临床前期实验中，肿瘤坏死因子相关凋亡诱导配体（TRAIL）与化疗药物在抗癌中存在协同作用。表阿霉素广泛应用于膀胱癌的辅助化疗中。在这里，我们假设膀胱癌中死亡受体 DR4和 DR5表达水平与膀胱癌患者的术后化疗及预后相关。方法采用免疫组化法检测229例经尿道切除术后的膀胱癌患者及癌旁正常组织中的DR4和DR5的表达。结果膀胱癌患者细胞质中 DR4和 DR5的表达率分别为75.1％和74．2％。DR4与 DR5均高表达的患者术后10年随访期间的无复发生存率明显好于低表达者。多变量分析显示 DR4（P＜0．001）、DR5（P＜0．001）的表达及表阿霉素的治疗（P＝0．034）是膀胱癌患者预后的独立指标，而且表阿霉素治疗能够明显提高DR4（P＝0．006）或DR5（P＝0．042）高表达的膀胱癌患者的无复发生存率。结论 DR4和DR5均高表达的患者可能更适合接受表阿霉素治疗。
목적：재림상전기실험중，종류배사인자상관조망유도배체（TRAIL）여화료약물재항암중존재협동작용。표아매소엄범응용우방광암적보조화료중。재저리，아문가설방광암중사망수체 DR4화 DR5표체수평여방광암환자적술후화료급예후상관。방법채용면역조화법검측229례경뇨도절제술후적방광암환자급암방정상조직중적DR4화DR5적표체。결과방광암환자세포질중 DR4화 DR5적표체솔분별위75.1％화74．2％。DR4여 DR5균고표체적환자술후10년수방기간적무복발생존솔명현호우저표체자。다변량분석현시 DR4（P＜0．001）、DR5（P＜0．001）적표체급표아매소적치료（P＝0．034）시방광암환자예후적독립지표，이차표아매소치료능구명현제고DR4（P＝0．006）혹DR5（P＝0．042）고표체적방광암환자적무복발생존솔。결론 DR4화DR5균고표체적환자가능경괄합접수표아매소치료。
Objective To explore the interrelationship of death receptors DR4 and DR5 expressions level with pa-tient prognosis and the response to adj uvant therapy in bladder cancer.Methods The expression of DR4 and DR5 was studied using immunohistochemistry of paraffin-embedded tumor specimens from 229 bladder cancer patients who had undergone transurethral resection.Results Cytoplasmic DR4,and DR5 expressions were detected in 75.1%,and 74.2% of bladder cancer patients,respectively.Patients with bladder cancer with either high DR4 or DR5 expression had a significantly longer postoperative recurrence-free rate than those with low expression of both during the 10-year follow-up.Multivariate analysis revealed that the expression of DR4 (P<.001),DR5(P<.001)and epirubicin therapy(P=.034)were independent prognostic indicators of bladder cancer.Furthermore,epirubicin therapy significantly improved recur-rence-free rate for the patients with DR4-high(P=.006)or DR5-high(P=.042)tumor.Conclusion Patients with high ex-pression of both DR4 and DR5 might benefit from epirubicin therapy.